Intramuscular hemangiomas of the mylohyoid and sternocleidomastoid muscle

Intramuscular hemangiomas of the head and neck are uncommon benign vascular tumors. They arise frequently in the masseter and trapezius muscle. However, intramuscular hemangiomas arising from the mylohyoid and sternocleidomastoid muscle are extremely rare. We, herein, report additional two cases with intramuscular hemangioma of the mylohyoid and sternocleidomastoid muscle, and review the literatures pertaining to this condition. Imaging studies such as magnetic resonance image (MRI) were diagnostic and the tumors were resected completely with the cuff of normal surrounding muscle. At follow-up examination the patients have been well, without evidence of tumor recurrence after surgery. Intramuscular hemangioma of the head and neck, despite its rarity, should be considered in the differential diagnosis of the head and neck masses.     

Intramasseter hemangiomas: a case report

Intramuscular hemangiomas are uncommon tumours in the head and neck region, especially in the masseter muscle. This article presents a case of a 10-year-old male treated by surgical excision. The authors review the literature to discuss the clinical characteristics, sex, age, differential diagnosis, surgical approaches, and histology.     

Hemangioma of the masseter muscle.

Intramuscular hemangiomas are rare benign tumors of vascular origin. The masseter is the muscle most commonly involved in the head and neck. A case of intramuscular masseter hemangioma is presented, the literature reviewed, and appropriate diagnostic modalities discussed.     

Head and neck intramuscular haemangioma: Report of two cases with unusual localization

Head and neck intramuscular haemangioma (IMH) is a benign, uncommon neoplasm arising most frequently in the masseter and trapezius muscles. It usually appears as an enlarging mass without specific clinical features and is therefore frequently misdiagnosed. We report two cases of IMH at unusual localizations: one involving the pterygoid muscles in a 30-year-old female and another one originating from the thyrohyoid muscles in a 38-year-old male. Preoperative evaluation included routine ENT examination, ultrasound (US) and CT scan. The preoperative clinical diagnoses were lymphangioma of the parapharyngeal space in the first case and atypical thyroid duct cyst in the second. Both patients were treated with open-neck approaches. The histopathologic diagnosis was capillary-type IMH in the first patient and cavernous-type IMH in the second. Postoperative courses were uneventful, and the patients were discharged within a few days. Clinical and US follow-ups were negative at 50 and 20 months, respectively. Preoperative diagnosis of head and neck IMH is rendered difficult by its rarity and non-specific clinical findings. Ample surgical excision is required for an adequate cure due to the frequent microscopically infiltrative pattern of diffusion of such a tumor into skeletal muscles, and long-term follow-up is mandatory to promptly treat any recurrence.     

Intramuscular hemangioma of the head and neck

Intramuscular hemangiomas are unusual tumors in the head and neck region that occur most frequently in the masseter muscle and are often confused with parotid neoplasms. Four cases are described and the literature reviewed. The diagnosis and management of these tumors are discussed in view of the fact that accurate preoperative diagnosis is unusual and tumor recurrence rates high. Increased awareness of the clinical presentation of intramuscular hemangiomas should enhance diagnostic accuracy and facilitate optimal treatment planning.     

Invasive intramuscular hemangiomas of the head and neck

Intramuscular hemangiomas make up less than 1% of all hemangiomas [1]. These invasive and aggressive lesions appear to have a predilection for large muscle masses. They can be strikingly aggressive in the head and neck, and persistence despite radical treatment is common. Spontaneous resolution in adults to our knowledge has not been reported in the literature. We present a case report of an invasive intramuscular hemangioma involving the parotid gland, the masseter and pterygoid muscles, and the infratemporal fossa after local resection of an apparently isolated lesion of the lip and the submandibular triangle. We describe a detailed course of treatment and review the literature.     

A rare case of intramuscular haemangioma in a six-year-old boy--a diagnostic dilemma

Intramuscular haemangiomas are uncommon tumours of the head and neck, occurring mainly in adults and usually located in the region of the masseter muscle and parotid gland. We report the case of a child with an intramuscular haemangioma over the left maxilla, which caused some diagnostic confusion in view of its atypical location combined with the unusual age and inflammatory mode of presentation.     

Rare intramuscular haemangioma of the sternocleidomastoid muscle

Intramuscular tumours of the head and neck often represent a differential diagnostic challenge. We report the rare case of an intramuscular haemangioma arising from the sternocleidomastoid muscle in the 6th decade. Pre-operative diagnosis was difficult, as these tumours are extremely uncommon in the head and neck region, with only very few cases reported in the literature. Due to the marked tendency of intramuscular hemangiomas to recur, accurate preoperative diagnosis forms the basis of adequate surgical therapy with sufficient safety margins.     

Seltenes intramuskul?res H?mangiom des M.?sternocleidomastoideus

Intramuscular tumours of the head and neck often represent a differential diagnostic challenge. We report the rare case of an intramuscular haemangioma arising from the sternocleidomastoid muscle in the 6^th decade. Pre-operative diagnosis was difficult, as these tumours are extremely uncommon in the head and neck region, with only very few cases reported in the literature. Due to the marked tendency of intramuscular hemangiomas to recur, accurate preoperative diagnosis forms the basis of adequate surgical therapy with sufficient safety margins.     

Rare case of intramasseteric cavernous hemangioma in a three-year-old boy: a diagnostic dilemma

Intramuscular hemangiomas are rare, benign tumors of vascular origin. The masseter is the muscle most commonly involved in the head and neck region. Because of their infrequency, deep location, and unfamiliar presentation, these lesions are seldom correctly diagnosed clinically. This case report presents a severe facial asymmetry caused by a left intramasseteric cavernous hemangioma in a 3-year-old boy. We were unaware of the exact nature of the tumor until intraoperative examination. The routine investigations performed before operation failed to establish a diagnosis. Surgical excision was performed, and 1 year after the operation we observed that the patient's facial asymmetry had been corrected. In this article, we review the literature on intramasseteric hemangioma, discuss the clinical and radiologic diagnostic methods, and review the treatment methods.     

Intramuscular hemangioma of masseter muscle with prominent formation of phleboliths: a case report

A 14-year-old girl was referred for evaluation and management of progressive, painful swelling of the right cheek. Swelling had been present since 3-year old and had gradually increased in size. Magnetic resonance imaging (MRI) revealed a well-circumscribed, brighter mass in the right masseter muscle with numerous rounded areas of signal hypointensity. Preoperative diagnosis was intramuscular hemangioma of the masseter muscle and surgery was performed. The tumor was completely removed except for a few, small phleboliths. Pathological examination of resected tissue led to a high suspicion of cavernous hemangioma with phlebolithiasis. Nine months postoperatively, the patient developed another painful mass in the right masseter muscle. MRI indicated recurrent hemangioma and further surgery was performed. Careful exploration resulted in completely removal of residual phleboliths accompanied with fibroadipose tissue. Part of the buccal branch of the facial nerve was excised to achieve complete resection of the lesion. Histological examination revealed distinct venous formation in phleboliths adjacent to fibroadipose tissue, demonstrating that both phleboliths and feeding vessels had been left by the previous operation. The present report reviews the literature on intramuscular hemangiomas of the masseter muscle, and discusses diagnostic methods and optimal surgical treatment.     

Intramuscular hemangioma in the head and neck.

Intramuscular hemangioma is a distinct type of hemangioma occurring within skeletal muscle and making up less than one per cent of all hemangiomas. They occur most often in the trunk and extremities, perhaps beacuse of the larger muscle volume in thos areas. 13.5 per cent of intramuscular hemangiomas do occur in the head and neck region and for this reason they should be considered in the differential diagnosis of head and neck masses. The first case of an intramuscular hemangioma of the digastric muscle is presented and confirmed by electron microscopic sections. An interesting finding in this tumor is the proliferation of both endothelial cells and pericytes. Hemangiomas are classified according to vessel size; "large vessel" cavernous, "small vessel" capillary, and "mixed". Various etiologies and modalities of treatment are discussed, and total excision with ligation of the feeding vessels is advocated to prevent the high incidence of later recurrence.     

Bilateral recurrent adult rhabdomyomas of the pharyngeal wall

Adult rhabdomyomas of the head and neck are uncommon benign skeletal muscle tumors. Only a few cases occurring in the pharyngeal wall have been described in the world literature. We present a case of recurrent bilateral rhabdomyomas in the pharynx and discuss the clinicopathological features of this lesion, comparing it to those of other neoplasms from which it must be differentiated. To our knowledge, bilaterality of this type of lesion has not been described previously. Although adult rhabdomyomas have a distinct histology, they often are mistaken for a variety of other lesions, particularly granular cell tumor. Received: 20 July 1998 / Accepted: 4 March 1999     

Congenital head and neck masses in infants and children. Part II

Congenital head and neck masses in children are a diverse group of lesions. Thyroglossal duct abnormalities are the most common, followed by branchial apparatus abnormalities, lymphangiomas (cystic hygroma), and subcutaneous vascular abnormalities (hemangioma, AVM). It is important to note that cutaneous hemangiomas are not included in this discussion of congenital masses. If they are considered within the general topic of congenital head and neck masses, vascular lesions by far are the most common. Teratomas and dermoid cysts represent true congenital neoplasms and are relatively uncommon. Several rare lesions have been noted in the discussion and should be included in the differential diagnosis. The diagnosis of these particular masses depends largely on history and physical examination. The location of the mass itself greatly limits the differential diagnosis. Ancillary studies such as plain x-rays, ultrasound, CT scanning, and angiography are useful in further limiting the possible diagnoses. Subcutaneous hemangiomas, ectopic thyroid, congenital goiter, and fibromatosis colli can be treated medically or with simple observation. Surgery is reversed for enlarging lesions or lesions affecting vital structures. The remainder of the congenital head and neck masses generally require early excisions to avoid complications of infection, airway obstruction, nutritional compromise, or the risk of malignant transformation.     

Intravascular endothelial papillary hyperplasia in the masseter muscle]

Intravascular Papillary Endothelial Hyperplasia (IVPEH) is a benign process, even uncommon. It was first described by Masson in 1923 under the name "Hemangioendotheliom vegetant intravascular". We present a case of IVPEH located in the masseter muscle. The treatment for this lesion was surgical excision. The histological examination is very important in order to separate this lesion from angiosarcoma.     

Intramuscular Hemangioma in the Anterior Scalene Muscle Diagnosed by Core Needle Biopsy

Intramuscular hemangioma (IMH) is a rare, benign vascular lesion that frequently develops within skeletal muscles. Preoperatively, accurate diagnosis of IMH is often extremely difficult because of nonspecific clinical findings and the inaccuracy of fine-needle aspiration cytology. IMH is suspected in only 8% of preoperative diagnoses before surgical exploration. Here, we report a case of a 44-year-old man with a huge IMH in the anterior scalene muscle that was preoperatively diagnosed using ultrasonography-guided core needle biopsy, and was successfully treated based on preoperative clinical information.     

Provocable tumor of the cheek as a manifestation of so-called "infiltrating lipoma" of the masseter muscle]

We report on a 29-year-old male patient, who presented at our outpatient clinic with a 6-year history of progressive swelling of the right cheek. Contraction of the masseter muscle increased the swelling. MR-Imaging revealed a tumor measuring 2 x 3 cm, which was located within the masseter muscle. The histological diagnosis was infiltrating lipoma, which to our knowledge has not been described in this area before. This particular type of lipoma is extremely rare in the head and neck. The diagnostic and therapeutic management of infiltrating lipoma is discussed, and guidelines for adequate follow-up suggested. In addition, the authors review other sites of this tumor and describe its histological characteristics and differential diagnosis.     

Intramuscular hemangioma of the scalene musculature masquerading as a paraganglioma: A case series

Intramuscular hemangiomas (IMHs) are uncommon benign vascular lesions, which develop in skeletal muscle. Herein, two cases of IMHs involving the cervical scalene musculature are presented. Such lesions are exceedingly rare, and can be difficult to distinguish from vagal paragangliomas based on clinical presentation, exam, and radiography. Complete surgical excision is the treatment of choice, and was successful in our two index patients. While rare, IMHs of the scalene muscles should be considered in the differential diagnosis of deep neck space masses.     

The influence of the masticatory muscles on craniofacial growth. A microsurgical study in the rat

Possible influence of masticatory muscles on facial growth was investigated in the rat by the formation of several experimental groups: excision of right masseter muscle of right temporal muscle, of both masseter muscles, of both temporal muscles and of both masseter and temporal muscles, section of inferior maxillary nerve and masseter transplantation. Results demonstrated that overall masticatory muscles provided equilibrium of masticatory function, any rupture of this equilibrium producing effects on mandibular growth and that of the facial mass.     

Adult laryngeal hemangioma CO2 laser excision. A single institution 3-year experience (Vittorio Veneto 2001-2003)

CONCLUSIONS: Adult supraglottic hemangiomas can be treated successfully with CO2 laser excision with limited morbidity. Extended laryngeal cavernous hemangiomas involving hypopharynx should be approached with staged CO2 laser surgical procedures. OBJECTIVES: Hemangioma of the adult larynx is an uncommon, benign lesion characterized by thin, friable mucosa overlying the vascular stroma. The optimal surgical approach to these lesions is still controversial because only anecdotal case reports or very limited series are available. We report a 3-year, retrospective, single institution study of the results of CO2 laser treatment of supraglottic hemangiomas in adults. PATIENTS AND METHODS: Six consecutive cases of adult laryngeal hemangioma were treated by the first author with CO2 laser microsurgery alone. RESULTS: In five of six cases, no recurrences have been diagnosed (median follow-up period: 29 months). One case presented limited persistence of disease in the retro-cricoid and arytenoids at 20-month follow-up control.